उच्च-जोखिम ऑस्टियोपोरोसिस जब प्रथम-पंक्ति एंटी-रिसोर्प्टिव थेरेपी हड्डी घनत्व लक्ष्यों को पूरा नहीं कर पाई

DOI: 10.1136/bmj‐2024‐081250

1. All recommend anti-resorptives as first line therapy for patients at high risk and osteoanabolics for those at very high risk.
2. AACE, Endocrine Society, and BHOF recommend a T-score based strategy when T ≤−2.5 at any site or a fixed risk threshold when T-score is between −2.5 and −1.0 if FRAX 10 year MOF is ≥20% or 10 year HF is ≥3%.
3. In practice, anti-resorptive-to-osteoanabolic transitions are common as osteoanabolics became available only in recent years and owing to cost constraints of osteoanabolics.
4. Experts recommend an improvement in total hip T-score of at least 0.2 units (3%) and in lumbar spine T-score of at least 0.5 units (6%), on the basis of reasonable chances of attaining such increments over three years by most therapies, including anti-resorptives.